Yttrium-90 radiation synovectomy in knee osteoarthritis: a prospective assessment at 6 and 12 months

Chatzopoulos, Dimitrios; Moralidis, Efstratios; Markou, Pavlos; Makris, Vassilios

doi:10.1097/mnm.0b013e32832b52b9

Cited by 22 publications

(16 citation statements)

References 23 publications

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“…Historically a common treatment for RA, radioactive synovectomy has also been evaluated in OA. 65 Improvements in pain and inflammation were noted, with the greatest effects seen in knees with the least radiologic evidence of damage. Isotopes of the lanthanide series of elements, such as Y 90 , Sm 153 , Er 169 and Yb 175 , are particularly suited to this purpose and their use has supplanted chemical synovectomy as the nonsurgical method of choice.…”

Section: Intra-articular Therapeuticsmentioning

confidence: 98%

Progress in intra-articular therapy

2013

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Diarthrodial joints are well suited to intra-articular injection, and the local delivery of therapeutics in this fashion brings several potential advantages to the treatment of a wide range of arthropathies. Possible benefits include increased bioavailability, reduced systemic exposure, fewer adverse events, and lower total drug costs. Nevertheless, intra-articular therapy is challenging because of the rapid egress of injected materials from the joint space; this elimination is true of both small molecules, which exit via synovial capillaries, and of macromolecules, which are cleared by the lymphatic system. In general, soluble materials have an intra-articular dwell time measured only in hours. Corticosteroids and hyaluronate preparations constitute the mainstay of FDA-approved intra-articular therapeutics. Recombinant proteins, autologous blood products and analgesics have also found clinical use via intra-articular delivery. Several alternative approaches, such as local delivery of cell and gene therapy, as well as the use of microparticles, liposomes, and modified drugs, are in various stages of preclinical development.

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Section: Intra-articular Therapeuticsmentioning

confidence: 98%

Progress in intra-articular therapy

2013

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“…Chatziopoulos et al (2009) assessed the outcome in patients with knee OA unresponsive to systematic or local medical treatment at 6 and 12 months after RSO with 90 Ycitrate. The results suggest that this form of therapy represents a safe and competent treatment option in osteoarthritic knee pain with scintigraphically established synovial inflammation, inadequately controlled by pharmacotherapy.…”

Section: Resultsmentioning

confidence: 99%

Radionuclide Therapy of Inflammatory Joint Diseases (Radiation Synovectomy, Radiosynoviorthesis)

Mödder¹

2013

Therapeutic Nuclear Medicine

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“…However, such an intervention may induce further articular damage and complications. Radiosynovectomy, which is a less invasive procedure is considered as an alternative therapeutic option for chronic inflammatory arthritis (15,16,17,18,19,20). Radiopharmaceutical excretion is not a concern since the application is local.…”

Section: Discussionmentioning

confidence: 99%

“…Radiosynovectomy is also used as an adjuvant therapy in patients with pigmented villonodular synovitis and hemophilic arthropathy (15,16,17,18,19,20). It seems that radiosynovectomy was safe and highly beneficial to children with hemophilic arthropathy.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Yttrium-90 Radiosynovectomy in Patients with Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome

Al‐Mayouf

Almutairi²,

Al‐Ismail³

2017

Mirt

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Objective:Camptodactyly-arthropathy-coxa-vara-pericarditis (CACP) syndrome is an autosomal recessive disorder caused by mutations in PRG4 gene that encodes for proteoglycan 4, the main lubricant for joints and tendon surfaces. It is a non-inflammatory arthropathy, characterized by joint effusions and synovial hypertrophy. So far, there is no effective treatment for this disorder. To evaluate the effectiveness of yttrium-90 radiosynovectomy in arthropathy of patients with CACP syndrome.Methods:Consecutive patients with CACP syndrome were prospectively evaluated at the enrollment and 3 months after the right knee injection with yttrium-90. The outcome variables were patient/parent and physician’s global assessment measured by a 3-point scale, right knee swelling and range of motion on a 3-point scale, in addition to magnetic resonance imaging (MRI) assessment of the right knee for bone, cartilage, fluid, synovial hypertrophy and soft tissue changes.Results:Six (three boys, three girls) patients with a mean age of 12 years and mean follow-up duration of 8.5 years completed a single right knee intra-articular yttrium-90 injection with 5 mCi. The procedure was well tolerated without adverse events apart from mild and transient joint pain in two patients. There was a minimal radioisotope leakage to soft tissue in two patients. During the 3-month follow-up interval, there was no improvement in the outcome variables. Patients and parents did not notice favorable therapeutic effects and global physician assessment was unsatisfactory. There was no difference in knee joint swelling or range of motion. Furthermore, MRI findings were unchanged. However, there was a minimal increase in synovial fluid post injection.Conclusion:Yttrium-90 radiosynovectomy seems to be a safe and well tolerated procedure, however, it did not show a beneficial therapeutic effect in arthropathy of CACP syndrome with the given dosage and interval. Studies including a larger number of patients and probably repeated injections are needed to derive satisfactory results about the effectiveness of yttrium-90 in CACP syndrome patients.

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Yttrium-90 radiation synovectomy in knee osteoarthritis: a prospective assessment at 6 and 12 months

Abstract: Yttrium-90 synovectomy exerts a beneficial therapeutic effect in a substantial proportion of patients with osteoarthritic knee pain and synovial inflammation, inadequately controlled by pharmacotherapy. Clinical improvement is inversely related to radiographic knee damage.

Cited by 22 publications

References 23 publications

Progress in intra-articular therapy

Progress in intra-articular therapy

Radionuclide Therapy of Inflammatory Joint Diseases (Radiation Synovectomy, Radiosynoviorthesis)

The Efficacy of Yttrium-90 Radiosynovectomy in Patients with Camptodactyly-Arthropathy-Coxa Vara-Pericarditis Syndrome

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